<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<title></title>
<!-- bootstrap table js -->
<script src="../bootstrapTable/dist/bootstrap-table.js"></script>
<script src="../bootstrapTable/dist/locale/bootstrap-table-zh-CN.js"></script>
<script src="ship.js"></script>
	<script type="text/javascript">
	$(function(){
		$('.change').hide();
	})
	</script>
</head>
<body>
		<div class="panel panel-primary">
			<div class="panel-heading">
				<h3 class="panel-title">申请单信息</h3>
			</div>

			<div class="panel-body">
				<form id="Business">
					<table class="table table-bordered">
					<tbody>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								报送机构：<span style="color:red;">*</span>
							</td>
							<td colspan="5">
    							<input style="width: 200px;" type="text" class="form-control" id="org" placeholder="请选择报送机构">
							</td>
						</tr>
					<!-- 
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								船舶名称：<span style="color:red;">*</span>
							</td>
							<td>
								<div class="input-group">
									<input type="text" class="form-control" disabled="disabled" id="ship" placeholder="选择船舶">
									<span class="input-group-btn">
										<button class="btn btn-primary" type="button" id="selectShip">
											选择船舶
										</button>
									</span>
								</div>
							</td>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								IMO编号：
							</td>
							<td>
    							<input type="text" class="form-control" name="imo" placeholder="IMO编号">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								申请单位名称：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="company" placeholder="请输入申请单位名称">
							</td>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								单位邮编：
							</td>
							<td>
    							<input type="text" class="form-control" name="postcode" placeholder="请输入单位邮编">
							</td>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								联系地址：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantnameCn" placeholder="请输入联系地址">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								手机：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantnameCn" placeholder="请输入手机号">
							</td>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								办公座机：
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantnameCn" placeholder="请输入办公座机号">
							</td>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								申办人姓名：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="proposer" placeholder="请输入申办人姓名">
							</td>
						</tr>
					 -->
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								船舶：<span style="color:red;">*</span>
							</td>
							<td>
								<div class="input-group" style="width:30%;">
									<input type="text" class="form-control" disabled="disabled" id="ship" placeholder="选择作业船舶">
									<span class="input-group-btn">
										<button class="btn btn-primary" type="button" id="selectShip">
											选择船舶
										</button>
									</span>
								</div>
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								保证期限：<span style="color:red;">*</span>
							</td>
							<td>
								  <div class="row">
								    <div class="col-lg-3">
								      <input type="date" class="form-control" name="ensurebegintime" placeholder="请输入保证开始时间">
								    </div>
								    <div class="col-lg-1" style="text-align: center;">
								      	至
								    </div>
								    <div class="col-lg-3">
								      <input type="date" class="form-control" name="ensureendtime" placeholder="请输入保证结束时间">
								    </div>
								  </div>
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								登记所有人名称（中文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantnameCn" placeholder="登记所有人名称（中文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								登记所有人名称（英文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantnameEn" placeholder="登记所有人名称（英文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								登记所有人主要营业地的完整地址（中文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantaddressCn" placeholder="登记所有人主要营业地的完整地址（中文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								登记所有人主要营业地的完整地址（英文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="registrantaddressEn" placeholder="登记所有人主要营业地的完整地址（英文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								保险人和/担保人名称（中文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="insurernameCn" placeholder="保险人和/担保人名称（中文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								保险人和/担保人名称（英文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="insurernameEn" placeholder="保险人和/担保人名称（英文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								保险人和/担保人地址（中文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="insureraddressCn" placeholder="保险人和/担保人地址（中文）">
							</td>
						</tr>
						<tr>
							<td style="width:130px; text-align: right; background-color: #eee; ">
								保险人和/担保人地址（英文）：<span style="color:red;">*</span>
							</td>
							<td>
    							<input type="text" class="form-control" name="insureraddressEn" placeholder="保险人和/担保人地址（英文）">
							</td>
						</tr>
					</tbody>
					</table>
					
	            </form>
			</div>
		</div>
</body>
</html>